Corneal Ectasia Management

The cornea is the front part of your eye that focuses light into the eye along with the lens. It is transparent, covering your iris, pupil, and anterior chamber.

The cornea can become damaged for various reasons such as inflammation, infection, trauma, and degeneration.

Irregularities in your cornea cause vision disturbances as a result of astigmatism.

This is a condition that involves architectural damage to the cornea. While the direct causes are not definite, rubbing of the eyes excessively and family history are considered substantial risk factors.

Prescription for Glasses

Patients with mild forms of keratoconus may benefit from a glasses prescription.

Contact Lenses

Hard contact lenses can be used to improve vision and better deal with cornea irregularities.

Corneal Cross-Linking (CXL)

This procedure strengthens and stabilized the cornea as it creates new links between collagen fibres within the cornea.

INTACS

This involves the insertion of semicircular plastic rings within the cornea to reduce the irregularity of the cornea. This allows patients to continue wearing glasses or contact lenses to see.

Corneal Transplantation

This is the removal and replacement of damaged and irregular cornea.

Penetrating Keratoplasty (PKP)

This involves the complete removal of the damaged cornea and replacement using a donor.

Deep Anterior Lamellare Keratoplasty (DALK)

This extremely technical procedure entails the removal of the damaged portion of the cornea only and the replacement of the cornea with a less thick donor.

Firstly, your eye will be frozen, washed, and cleansed. This procedure is pain-free and typically takes one hour to complete. Patients usually remain awake for the procedure. Once the operation is complete, a bandage contact lens will be placed on your eye and a clear plastic shield over it. You will be provided specific instructions for the use of eye drops and pain medication to ensure healing.

Itching, mild discomfort, fluid discharge, and light sensitivity are common post-procedure. Your vision may be less clear before the procedure; however, it generally is restored to either baseline or potentially better than it was before the procedure.

While issues after corneal cross-linking are rare, they are still possible. These issues may include infection, inflammation, raised intraocular pressure, corneal haze, and less commonly corneal edema and decompensation. In most cases, these problems can be treated successfully with prompt attention.

Your healing eye needs time to adjust and focus properly. For most patients, their vision returns to baseline over several months, but it could take longer. Be sure to ask your doctor when the appropriate time is to resume driving.

Corneal cross-linking is intended for patients with evidence of progression caused by ectasia condition; however, it is not suitable for everyone with ectasia. Your doctor will determine your candidacy.

Dr. Theo Seiler is a world-renowned Ophthalmologist. After extensive studies performed in the laboratory and clinical studies, by Dr. Spoerl (a basic scientist), the two concluded that Ultraviolet light and Riboflavin produce increased strength in collagen molecules in the cornea. This led to the discovery of corneal cross-linking to stop keratoconus and other ectatic conditions. Approximately 7000 procedures have been performed worldwide to date. Dr. Al-Ghoul has had the pleasure of learning under the guidance of Dr. Theo Seiler in Zurich, Switzerland. Dr. Al-Ghoul is the first Ophthalmologist in Alberta to introduce this technique, which is now performed throughout Canada.

Dr. Al-Ghoul with Dr. Theo Seiler